随着人们生活水平的不断提高,心血管疾病(cardiovascular disease, CVD)目前已经排在全球致死疾病中的首位,对人类健康产生了严重威胁,同时也是当前全世界经济负担最重的疾病。2型糖尿病(type 2 diabetes mellitus, T2DM)是各种CVD的独...随着人们生活水平的不断提高,心血管疾病(cardiovascular disease, CVD)目前已经排在全球致死疾病中的首位,对人类健康产生了严重威胁,同时也是当前全世界经济负担最重的疾病。2型糖尿病(type 2 diabetes mellitus, T2DM)是各种CVD的独立危险因素,包括冠心病,心力衰竭(heart failure, HF),中风,外周动脉疾病(peripheral arterial disease, PAD)等。T2DM患者发生CVD的风险较高,极易致使患者出现微血管病变或者大血管病变,其中冠状动脉病变在血管病变中危害性最大。胰岛素抵抗(insulin resistance, IR)是T2DM和CVD的共同病理生理基础,评估IR状态对CVD的防治大有裨益。目前评估IR的方法种类繁多,葡萄糖钳夹技术(glucose clamp technique, GCT)、胰岛素稳态模型技术(homeostatic model assessment of insulin resistance, HOMA-IR)等传统评价方式以其独特的优势使其在某些方面仍然不可替代,但是这些传统评估方法也存在一定的局限性,比如程序步骤相对繁琐复杂、可重复性差、对受试者依从性要求较高等使其不适用于大规模的、常规的临床评估。近年来涌现出诸多新型评估IR的方法,可以通过简单的常规生化测试计算,其在一定程度上弥补了传统IR评估方法的缺点且评估效能不亚于传统评价指标。本文主要阐述IR及其新型评价指标与CVD相关性研究进展。With the continuous improvement of people’s living standards, cardiovascular disease (CVD) has now ranked as the leading cause of death globally, posing a serious threat to human health and being the most economically burdensome disease worldwide. Type 2 diabetes mellitus (T2DM) is an independent risk factor for various cardiovascular diseases, including coronary heart disease, heart failure, stroke, and peripheral arterial disease. Patients with T2DM have a higher risk of developing cardiovascular diseases and are prone to microvascular and macrovascular complications, with coronary artery disease being the most harmful among vascular complications. Insulin resistance (IR) is the common pathophysiological basis of T2DM and CVD, and assessing IR status is beneficial for the prevention and treatment of CVD. Currently, there are many methods for evaluating IR, including the glucose clamp technique (GCT) and the homeostatic model assessment of insulin resistance (HOMA-IR), which have unique advantages and remain unreplaceable in some aspects, but these traditional assessment methods also have certain limitations, such as relatively complex procedural steps, poor reproducibility, and high requirements for the subjects’ compliance, which make them unsuitable for large-scale, routine clinical assessment. In recent years, many novel methods for evaluating IR have emerged, which can be calculated through simple routine biochemical tests. To some extent, these new IR evaluation methods have made up for the shortcomings of traditional IR evaluation methods and have comparable evaluation efficacy to traditional indicators. This article mainly discusses the research progress of the correlation between IR and its novel evaluation indexes with cardiovascular diseases.展开更多
目的:本研究基于美国国家健康与营养调查(National Health and Nutrition Examination Survey, NHANES)数据库,旨在探讨幽门螺杆菌(Helicobacter pylori, H. pylori)感染与胰岛素抵抗(Insulin Resistance, IR)替代指标之间的关系。方法...目的:本研究基于美国国家健康与营养调查(National Health and Nutrition Examination Survey, NHANES)数据库,旨在探讨幽门螺杆菌(Helicobacter pylori, H. pylori)感染与胰岛素抵抗(Insulin Resistance, IR)替代指标之间的关系。方法:选取NHANES数据库1999~2000年横断面调查的参与者数据;采用单因素及多因素Logistic回归分析H. pylori感染的影响因素;通过多模型的Logistic回归分析H. pylori感染与IR替代指标的关联性,进行了亚组分析,以确保结果稳定。结果:最终纳入1446名参与者,H. pylori感染的总体患病率为41.8%,平均年龄为50.9岁。校正全部混杂因素后,甘油三酯葡萄糖(triglyceride glucose index, TyG)指数、甘油三酯葡萄糖–腰高比(triglyceride glucose-waist to height ratio, TyG-WHtR)和胰岛素抵抗代谢(metabolic score for insulin resistance, METS-IR)指数与H. pylori感染仍然呈现正相关。按年龄、性别、种族、吸烟、饮酒状况进行的亚组分析显示,无统计学显著性相互作用(P > 0.05)。结论:本研究结果表明,TyG指数、TyG-WHtR指数和METS-IR与H. pylori感染的风险有关,为未来研究提供了潜在的生物标志物。Objective: This study explores the relationship between Helicobacter pylori (H. pylori) infection and surrogate markers of insulin resistance (IR) using data from the National Health and Nutrition Examination Survey (NHANES) database. Methods: Data from the 1999~2000 NHANES cross-sectional survey were analyzed. Univariate and multivariate logistic regression models were used to identify factors influencing H. pylori infection. The association between H. pylori infection and IR surrogate markers was further assessed using multiple logistic regression models, with subgroup analyses conducted for robustness. Results: The study included 1446 participants, with an H. pylori infection prevalence of 41.8% and an average age of 50.9 years. After adjusting for confounders, the triglyceride glucose (TyG) index, triglyceride glucose-waist to height ratio (TyG-WHtR), and metabolic score for insulin resistance (METS-IR) index remained positively associated with H. pylori infection. Subgroup analyses by age, gender, ethnicity, smoking, and alcohol use revealed no statistically significant interactions (P > 0.05). Conclusion: These findings indicate that the TyG index, TyG-WHtR, and METS-IR are associated with an increased risk of H. pylori infection, highlighting their potential as biomarkers for further research.展开更多
文摘随着人们生活水平的不断提高,心血管疾病(cardiovascular disease, CVD)目前已经排在全球致死疾病中的首位,对人类健康产生了严重威胁,同时也是当前全世界经济负担最重的疾病。2型糖尿病(type 2 diabetes mellitus, T2DM)是各种CVD的独立危险因素,包括冠心病,心力衰竭(heart failure, HF),中风,外周动脉疾病(peripheral arterial disease, PAD)等。T2DM患者发生CVD的风险较高,极易致使患者出现微血管病变或者大血管病变,其中冠状动脉病变在血管病变中危害性最大。胰岛素抵抗(insulin resistance, IR)是T2DM和CVD的共同病理生理基础,评估IR状态对CVD的防治大有裨益。目前评估IR的方法种类繁多,葡萄糖钳夹技术(glucose clamp technique, GCT)、胰岛素稳态模型技术(homeostatic model assessment of insulin resistance, HOMA-IR)等传统评价方式以其独特的优势使其在某些方面仍然不可替代,但是这些传统评估方法也存在一定的局限性,比如程序步骤相对繁琐复杂、可重复性差、对受试者依从性要求较高等使其不适用于大规模的、常规的临床评估。近年来涌现出诸多新型评估IR的方法,可以通过简单的常规生化测试计算,其在一定程度上弥补了传统IR评估方法的缺点且评估效能不亚于传统评价指标。本文主要阐述IR及其新型评价指标与CVD相关性研究进展。With the continuous improvement of people’s living standards, cardiovascular disease (CVD) has now ranked as the leading cause of death globally, posing a serious threat to human health and being the most economically burdensome disease worldwide. Type 2 diabetes mellitus (T2DM) is an independent risk factor for various cardiovascular diseases, including coronary heart disease, heart failure, stroke, and peripheral arterial disease. Patients with T2DM have a higher risk of developing cardiovascular diseases and are prone to microvascular and macrovascular complications, with coronary artery disease being the most harmful among vascular complications. Insulin resistance (IR) is the common pathophysiological basis of T2DM and CVD, and assessing IR status is beneficial for the prevention and treatment of CVD. Currently, there are many methods for evaluating IR, including the glucose clamp technique (GCT) and the homeostatic model assessment of insulin resistance (HOMA-IR), which have unique advantages and remain unreplaceable in some aspects, but these traditional assessment methods also have certain limitations, such as relatively complex procedural steps, poor reproducibility, and high requirements for the subjects’ compliance, which make them unsuitable for large-scale, routine clinical assessment. In recent years, many novel methods for evaluating IR have emerged, which can be calculated through simple routine biochemical tests. To some extent, these new IR evaluation methods have made up for the shortcomings of traditional IR evaluation methods and have comparable evaluation efficacy to traditional indicators. This article mainly discusses the research progress of the correlation between IR and its novel evaluation indexes with cardiovascular diseases.
文摘目的:本研究基于美国国家健康与营养调查(National Health and Nutrition Examination Survey, NHANES)数据库,旨在探讨幽门螺杆菌(Helicobacter pylori, H. pylori)感染与胰岛素抵抗(Insulin Resistance, IR)替代指标之间的关系。方法:选取NHANES数据库1999~2000年横断面调查的参与者数据;采用单因素及多因素Logistic回归分析H. pylori感染的影响因素;通过多模型的Logistic回归分析H. pylori感染与IR替代指标的关联性,进行了亚组分析,以确保结果稳定。结果:最终纳入1446名参与者,H. pylori感染的总体患病率为41.8%,平均年龄为50.9岁。校正全部混杂因素后,甘油三酯葡萄糖(triglyceride glucose index, TyG)指数、甘油三酯葡萄糖–腰高比(triglyceride glucose-waist to height ratio, TyG-WHtR)和胰岛素抵抗代谢(metabolic score for insulin resistance, METS-IR)指数与H. pylori感染仍然呈现正相关。按年龄、性别、种族、吸烟、饮酒状况进行的亚组分析显示,无统计学显著性相互作用(P > 0.05)。结论:本研究结果表明,TyG指数、TyG-WHtR指数和METS-IR与H. pylori感染的风险有关,为未来研究提供了潜在的生物标志物。Objective: This study explores the relationship between Helicobacter pylori (H. pylori) infection and surrogate markers of insulin resistance (IR) using data from the National Health and Nutrition Examination Survey (NHANES) database. Methods: Data from the 1999~2000 NHANES cross-sectional survey were analyzed. Univariate and multivariate logistic regression models were used to identify factors influencing H. pylori infection. The association between H. pylori infection and IR surrogate markers was further assessed using multiple logistic regression models, with subgroup analyses conducted for robustness. Results: The study included 1446 participants, with an H. pylori infection prevalence of 41.8% and an average age of 50.9 years. After adjusting for confounders, the triglyceride glucose (TyG) index, triglyceride glucose-waist to height ratio (TyG-WHtR), and metabolic score for insulin resistance (METS-IR) index remained positively associated with H. pylori infection. Subgroup analyses by age, gender, ethnicity, smoking, and alcohol use revealed no statistically significant interactions (P > 0.05). Conclusion: These findings indicate that the TyG index, TyG-WHtR, and METS-IR are associated with an increased risk of H. pylori infection, highlighting their potential as biomarkers for further research.
